HESI PN Exit Exams COMPILED
Comprehensive Question Banks A
Graded Elsevier | Verified Questions
HESI PN Exit Exams COMPILED Comprehensive Question |
Comprehensive Examination
HESI PN Exit Exams COMPILED Comprehensive Question
Banks A Graded Elsevier actual exam preparation document
with verified questions, complete answers, and focused
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI PN Exit Exams COMPILED Comprehensive
Question Banks A Graded Elsevier. Every item uses a focused
exam stem, four response options, a keyed response, and a clear
rationale, making it easier to understand the subject, spot
distractors, and build real exam confidence.
Page 1
, Question 1
A patient receiving continuous IV heparin at 18 units/kg/hr has an aPTT of 96
seconds (therapeutic range 60-80 seconds) and new hematuria. Which action
should the nurse anticipate implementing first?
A. Administer vitamin K 10 mg IV push
B. Stop the heparin infusion and prepare to administer protamine sulfate
C. Continue the infusion and recheck aPTT in 6 hours
D. Administer fresh frozen plasma and maintain the current rate
Correct Answer: B - Stop the heparin infusion and prepare to
administer protamine sulfate
RATIONALE
An aPTT above therapeutic range with bleeding indicates heparin
excess; the infusion must be stopped and protamine sulfate given as
the antidote. Vitamin K reverses warfarin, not heparin; continuing the
infusion worsens bleeding; FFP is not first-line for heparin reversal.
Question 2
A patient with bipolar I disorder is started on lithium carbonate. Which
statement by the patient indicates a correct understanding of discharge
teaching?
A. I will increase my salt intake during hot weather.
B. I should take ibuprofen for headaches instead of acetaminophen.
C. I will maintain a consistent sodium and fluid intake daily.
D. I can stop the medication once my mood stabilizes.
Correct Answer: C - I will maintain a consistent sodium and fluid
intake daily.
Page 2
, RATIONALE
Lithium levels are inversely affected by sodium and fluid changes;
consistent intake prevents toxicity. Increased salt lowers lithium
levels; NSAIDs like ibuprofen increase lithium levels; abrupt
discontinuation risks relapse.
Question 3
A laboring patient at 39 weeks has a Category III fetal heart tracing with
recurrent late decelerations and minimal variability. Which intrauterine
resuscitation measure has the highest priority?
A. Administer oxygen at 10 L/min via nonrebreather mask
B. Reposition the patient to left lateral and increase IV fluid rate
C. Prepare for immediate cesarean delivery
D. Perform a sterile vaginal exam to assess dilation
Correct Answer: C - Prepare for immediate cesarean delivery
RATIONALE
Category III tracing with recurrent late decelerations and minimal
variability indicates fetal hypoxemia and requires immediate delivery.
While repositioning and oxygen are supportive, they do not delay the
need for expedited delivery; vaginal exam is not the priority.
Question 4
A postoperative patient with a chest tube drainage system suddenly has
continuous bubbling in the water-seal chamber. Which action should the nurse
take first?
A. Clamp the chest tube near the insertion site
B. Assess the insertion site and tubing for an air leak
C. Add sterile water to the water-seal chamber
D. Notify the provider and obtain a stat chest x-ray
Correct Answer: B - Assess the insertion site and tubing for an air
Page 3
, leak
RATIONALE
Continuous bubbling in the water-seal chamber indicates an air leak;
the nurse must first assess the system to locate the source. Clamping
can cause tension pneumothorax; adding water is for low water level,
not bubbling; notifying the provider comes after assessment.
Question 5
A patient is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours.
The patient weighs 176 lb. The pharmacy supplies enoxaparin 80 mg/0.8 mL.
How many milliliters will the nurse administer per dose?
A. 0.8 mL
B. 1.0 mL
C. 1.2 mL
D. 0.6 mL
Correct Answer: A - 0.8 mL
RATIONALE
Weight is 176 lb ÷ 2.2 = 80 kg; dose = 80 mg. With 80 mg/0.8 mL
concentration, 80 mg = 0.8 mL. Other options reflect calculation
errors (e.g., using 1 mg/mL or incorrect weight conversion).
Question 6
A community health nurse is planning interventions to reduce the incidence of
sudden infant death syndrome (SIDS). Which recommendation reflects the
most current evidence-based practice?
A. Place infants on their side for sleep
B. Offer a pacifier at nap and bedtime after breastfeeding is established
C. Use loose blankets to keep the infant warm
D. Share the bed with the infant for closer monitoring
Page 4
Comprehensive Question Banks A
Graded Elsevier | Verified Questions
HESI PN Exit Exams COMPILED Comprehensive Question |
Comprehensive Examination
HESI PN Exit Exams COMPILED Comprehensive Question
Banks A Graded Elsevier actual exam preparation document
with verified questions, complete answers, and focused
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI PN Exit Exams COMPILED Comprehensive
Question Banks A Graded Elsevier. Every item uses a focused
exam stem, four response options, a keyed response, and a clear
rationale, making it easier to understand the subject, spot
distractors, and build real exam confidence.
Page 1
, Question 1
A patient receiving continuous IV heparin at 18 units/kg/hr has an aPTT of 96
seconds (therapeutic range 60-80 seconds) and new hematuria. Which action
should the nurse anticipate implementing first?
A. Administer vitamin K 10 mg IV push
B. Stop the heparin infusion and prepare to administer protamine sulfate
C. Continue the infusion and recheck aPTT in 6 hours
D. Administer fresh frozen plasma and maintain the current rate
Correct Answer: B - Stop the heparin infusion and prepare to
administer protamine sulfate
RATIONALE
An aPTT above therapeutic range with bleeding indicates heparin
excess; the infusion must be stopped and protamine sulfate given as
the antidote. Vitamin K reverses warfarin, not heparin; continuing the
infusion worsens bleeding; FFP is not first-line for heparin reversal.
Question 2
A patient with bipolar I disorder is started on lithium carbonate. Which
statement by the patient indicates a correct understanding of discharge
teaching?
A. I will increase my salt intake during hot weather.
B. I should take ibuprofen for headaches instead of acetaminophen.
C. I will maintain a consistent sodium and fluid intake daily.
D. I can stop the medication once my mood stabilizes.
Correct Answer: C - I will maintain a consistent sodium and fluid
intake daily.
Page 2
, RATIONALE
Lithium levels are inversely affected by sodium and fluid changes;
consistent intake prevents toxicity. Increased salt lowers lithium
levels; NSAIDs like ibuprofen increase lithium levels; abrupt
discontinuation risks relapse.
Question 3
A laboring patient at 39 weeks has a Category III fetal heart tracing with
recurrent late decelerations and minimal variability. Which intrauterine
resuscitation measure has the highest priority?
A. Administer oxygen at 10 L/min via nonrebreather mask
B. Reposition the patient to left lateral and increase IV fluid rate
C. Prepare for immediate cesarean delivery
D. Perform a sterile vaginal exam to assess dilation
Correct Answer: C - Prepare for immediate cesarean delivery
RATIONALE
Category III tracing with recurrent late decelerations and minimal
variability indicates fetal hypoxemia and requires immediate delivery.
While repositioning and oxygen are supportive, they do not delay the
need for expedited delivery; vaginal exam is not the priority.
Question 4
A postoperative patient with a chest tube drainage system suddenly has
continuous bubbling in the water-seal chamber. Which action should the nurse
take first?
A. Clamp the chest tube near the insertion site
B. Assess the insertion site and tubing for an air leak
C. Add sterile water to the water-seal chamber
D. Notify the provider and obtain a stat chest x-ray
Correct Answer: B - Assess the insertion site and tubing for an air
Page 3
, leak
RATIONALE
Continuous bubbling in the water-seal chamber indicates an air leak;
the nurse must first assess the system to locate the source. Clamping
can cause tension pneumothorax; adding water is for low water level,
not bubbling; notifying the provider comes after assessment.
Question 5
A patient is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours.
The patient weighs 176 lb. The pharmacy supplies enoxaparin 80 mg/0.8 mL.
How many milliliters will the nurse administer per dose?
A. 0.8 mL
B. 1.0 mL
C. 1.2 mL
D. 0.6 mL
Correct Answer: A - 0.8 mL
RATIONALE
Weight is 176 lb ÷ 2.2 = 80 kg; dose = 80 mg. With 80 mg/0.8 mL
concentration, 80 mg = 0.8 mL. Other options reflect calculation
errors (e.g., using 1 mg/mL or incorrect weight conversion).
Question 6
A community health nurse is planning interventions to reduce the incidence of
sudden infant death syndrome (SIDS). Which recommendation reflects the
most current evidence-based practice?
A. Place infants on their side for sleep
B. Offer a pacifier at nap and bedtime after breastfeeding is established
C. Use loose blankets to keep the infant warm
D. Share the bed with the infant for closer monitoring
Page 4
